Healthcare Provider Details

I. General information

NPI: 1609316231
Provider Name (Legal Business Name): BRIANNA ASHLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 E 70TH ST STE C
SHREVEPORT LA
71105-5345
US

IV. Provider business mailing address

6005 GRAY FOX CIR
SHREVEPORT LA
71129-3511
US

V. Phone/Fax

Practice location:
  • Phone: 318-294-0344
  • Fax:
Mailing address:
  • Phone: 318-294-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10243
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: